Characterizing brain dynamic biomarkers of fentanyl using intracranial and high-density electroencephalogram in humans

阿片类药物过量死亡仍然是美国主要的公共卫生问题。现在人们认识到， 术后疼痛是阿片类药物持续使用和依赖的主要原因。管理不到位 术中伤害感受的增加可导致术后疼痛增加，这可导致阿片类药物增加。 使用，慢性疼痛，阿片类药物依赖和阿片类药物滥用。在这种围手术期环境中， 病人要么失去知觉（在手术室），要么严重镇静（在麻醉后护理 单位），不能报告他们的疼痛程度。在这些情况下，麻醉师和护士只能猜测 阿片类药物的需求，因为他们没有办法实时测量阿片类药物的效果。一 阿片类药物作用的实时测量，如果存在的话，将允许麻醉师和护士 精确滴定阿片类药物，可显著改善术后疼痛管理和后续率 阿片类药物使用、依赖和过量。在过去的两年里，我的实验室开发了一个真实的- 阿片类药物的时间生物标志物，可用于提供更精确的阿片类药物滴定， 发现应用程序。在这个项目中，我们建议调查这种生物标志物的机制 并开发进一步的转化科学以支持该生物标志物的临床应用。

Opioid overdose deaths remain a major public health problem in the US. It is now recognized that surgery and post-operative pain are major contributors to persistent opioid use and dependence. Inadequate management of intraoperative nociception can lead to increased post-operative pain, which can lead to increased opioid utilization, chronic pain, opioid dependence, and opioid abuse. In this perioperative setting a major challenge is that patients are either unconscious (in the operating room) or heavily sedated (in the post-anesthesia care unit) and cannot report their pain levels. In these scenarios, anesthesiologists and nurses can only guess the opioid requirements for their patients, as they have no means to measure opioid drug effects in real-time. A real-time measurement of opioid drug effects, if it existed, would allow anesthesiologists and nurses to precisely titrate opioids and could significantly improve post-operative pain management and subsequent rates of opioid utilization, dependence, and overdose. Over the past two years my laboratory has developed a real- time biomarker for opioid drugs that could be used to provide more precise titration of opioid drugs and for drug discovery applications. In this project we propose to investigate the mechanisms underlying this biomarker and develop further translational science to support clinical application of this biomarker.